Individual
BAILEY LEE CHELEMEDOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
8899 UNIVERSITY CENTER LN STE 245, SAN DIEGO, CA 92122-1010
(858) 955-0089
Mailing address
1825 NICOLA DR, PETALUMA, CA 94954-5792
(415) 990-4171
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
109813
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2023
Last updated
06/08/2024
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